Nurses’ Long Hours Lead to Worse Patient Outcomes, Study Suggests

Hospitals in which nurses work long hours have higher rates of patients deaths from pneumonia and acute myocardial infarction, according to a new study.

Researchers at the University of Maryland School of Nursing and Johns Hopkins School of Medicine conducted a study of nurses’ work schedules, staffing and patient outcomes as part of ongoing research funded by the National Council of State Boards of Nursing.

In the study — “Nurses’ Work Schedule Characteristics, Nurse Staffing, and Patient Mortality,” which appears in the January/February issue of Nursing Research — the authors examined patient outcomes and staffing information from 71 acute care hospitals in Illinois and North Carolina. They compared the data with survey responses of 633 randomly selected nurses who worked at the hospitals.

Long work hours and lack of time off were the components most frequently linked to patient mortality. Co-author Alison Trinkoff, RN, ScD, MPH, FAAN, professor at the Maryland School of Nursing, said nurses need time off to rest and recuperate for their own health and to ensure a high level of performance on the job.

In the study, pneumonia deaths were significantly more likely in hospitals where nurses reported schedules with long hours and lack of time away from work. Patient incidence of abdominal aortic aneurysm also was associated with lack of time off for nurses. Mortality in patients with congestive heart failure was associated with nurses who worked while sick. Acute myocardial infarction was associated significantly with nurses’ weekly burden, specifically hours per week and consecutive days.

In previous papers, the authors cited data challenging the 12-hour work shift model, which they said can lead to sleep deprivation, health problems and a greater likelihood of errors when treating patients. They also examined barriers that keep nursing executives from reducing the duration of nurses’ shifts and offered strategies to help mitigate potentially detrimental effects of 12-hour shifts.

With the latest study linking patient deaths from pneumonia and acute myocardial infarction to longer shifts, the authors hope to call new attention to the issue.

“Now that we have data that these conditions affect the public adversely, there is even more reason for providers in each hospital and clinic to look at the situation and find more solutions,” Trinkoff said.